Dialing down breathing

People with hypertension find they can lower their blood pressure with electronic device

People with hypertension find they can lower their blood pressure with electronic device

September 20, 2006|DAVID RUMBACH Tribune Staff Writer

SOUTH BEND -- Everybody knows how to face a stressful moment. You just stand back and take a deep breath. But researchers say slow, deep breathing can do much more than calm a person's nerves. It appears to curb chronic high blood pressure in people with that dangerous condition. Studies conducted in the United States, Israel and Italy have shown that people with hypertension can lower their average blood pressure significantly by sitting quietly and breathing deeply for 15 minutes a day. The people in the studies were aided by a biofeedback device called Resperate that measures a person's breathing rate and coaches him or her to slow it to a crawl. The non-prescription device, sold on the Internet for $300, is competing in a market already crowded with more than 120 blood pressure medications. But new approaches are badly needed, said Dr. William J. Elliott, a professor of preventive medicine at Rush Medical College in Chicago. Of the 68 million people with high blood pressure in the United States, more than a third are receiving inadequate treatment -- or no treatment at all. "Many people stop taking pills after a year -- about 50 percent,'' said Elliott, a member of the scientific advisory board for the company that makes Resperate. There's a lot at stake. Hypertension increases a person's risk for heart attack, stroke, heart failure and kidney failure. According to the American Heart Association, it causes 50,000 deaths a year and contributes to an additional 250,000 deaths. Fishing for a complement When Eduardo Zambrano heard about his father's high blood pressure, he knew that a doctor undoubtedly would give him a drug. But Zambrano, an assistant professor of finance at the University of Notre Dame who leads a weekly meditation group, wanted his father to benefit from a complementary, nonpharmaceutical therapy as well. As he does whenever a family member gets sick, Zambrano turned to the Web for help. An ad, on the site of holistic health advocate Dr. Andrew Weil, introduced him to the Resperate device. Deciding whether to plunk down money for the device was cause for some meditation -- literally. "I tried slow breathing, not with the machine but with meditation,'' said Zambrano, who has practiced meditation in the Buddhist tradition for more than a decade. "I thought, 'I can see why this would work.'æ'' Guiding tones With its hand-held computer and headphones, the Resperate looks like a plump Walkman CD player. One thing, however, is added on -- a small motion sensor that you wear on a belt, either around your chest or around your belly, depending on which moves. The sensor measures your breathing rate, and the computer creates pleasant tones that are synchronized with your breathing -- a higher tone for inhaling and a lower one for exhaling. The device guides the user to ever deeper breathing by gradually lengthening the tones. Most people breathe about 15 times per minute during waking hours. The device brings that down to a supposed "therapeutic rate'' of 10 breaths per minute and even lower. South Bend yoga instructor Steve Krojniewski reached three breaths per minute when he tried a Resperate device provided by The Tribune. He said the relaxed state induced by the machine reminded him of the meditation and focused breathing he has his students do at the close of a yoga session. Controlled deep breathing is an essential element of yoga, as important as the poses. "I think this is a great tool to teach people how to breath,'' he said. Zambrano believes anyone experienced in meditation could achieve therapeutic breathing rates on his or her own. Others, like his father, would benefit from an electronic guide. "If I taught him how to meditate, he wouldn't know how to do it on his own,'' he said. "But with this, he might. He likes gadgets.'' Supporting evidence James Lecklider of South Bend credits slow breathing with bringing his high blood pressure closer to normal levels. Lecklider, who owns a security firm based at his house, said he likes to "think outside the box'' when it comes to health care. "I wasn't getting results with those pills,'' he said. He began using a Resperate device last October. He still uses it about three times a week, and takes his own blood pressure regularly. "I'm in the 120s, sometimes the 130s,'' he said. "I don't get the 150s like I did before.'' Lecklider's success does not appear to be a fluke. InterCure, the company that sells Resperate, says seven scientific studies back its effectiveness, including four higher-quality studies in which subjects were randomly assigned to control or treatment groups. One of the more recent of those studies was conducted at Rush Medical College in Chicago and published in the October 2004 Journal of Clinical Hypertension. It found that people who used the device for at least 180 minutes over eight weeks achieved a 15-point drop in their systolic blood pressure, the top number in blood pressure readings. It dropped from 150 at the beginning of the study to 135 at the end. That's roughly equivalent to what people achieve with their starting dose of medicine, said Elliott, one of the authors of the study. David E. Anderson, an investigator with the behavioral hypertension unit of the National Institute on Aging, said more research is needed. "It's not a settled question, but there are encouraging indications that this works,'' he said. Anderson is principal investigator for one of those follow-up studies. His investigation, funded by the National Institutes of Health, will try to figure out why slow breathing appears to lower blood pressure. Arteries like plumbing Blood pressure works like water in pipes: It varies with the diameter of the vessels and the amount of fluid. And so the body, in a variety of ways, controls blood pressure by either making the arteries and veins bigger or smaller, or by increasing or decreasing the volume of blood circulating in the bloodstream. The kidneys, the body's blood filters, play a key role. They vary blood volume by allowing more or less sodium to go into the bloodstream. What has breathing got to do with all this? Anderson's theory is that deep breathing lowers blood pressure indirectly by reducing the amount of carbon dioxide in the blood. Excess carbon dioxide makes the blood slightly acidic, he said. The kidneys, sensitive to acidity in blood, respond by increasing the blood volume, diluting the acidity by bumping up blood pressure. In Anderson's study, to be done at Harbor Hospital in Baltimore, investigators will measure the amount of carbon dioxide in the blood of people before and after 28 days of guided breathing. "We would expect CO2 to go down slightly,'' he said. They also will measure levels of a newly discovered molecule that inhibits sodium transport across cell walls. By a roundabout biochemical process, an excess of this molecule (marinobufagenin) leads to an excess of calcium in the arterial walls, making them stiff and inelastic. Stiff arteries are another factor in blood pressure. Investigators in Anderson's study also will see if using Resperate 15 minutes a day changes the way people breathe while sleeping. The idea being tested is that the electronic guide teaches people a healthy habit: breathing more deeply. Staff writer David Rumbach:drumbach@sbtinfo.com(574) 235-6358